The last decade has seen rapid growth in the public profile and availability of gambling in the U.S. The laws regulating gambling have been liberalized, and public approval of gambling may have grown. These developments have given rise to controversy about gambling policy, but relevant empirical data is sparse. Are Americans gambling more, and has there been an increase in problem gambling? Do more permissive laws, increased social approval and greater gambling opportunities lead to more problem gambling? Has there been an increase in the tendency for problem gambling to concentrate in disadvantaged neighborhoods? How similar is gambling to alcohol and drug abuse, and is there an increase in the co-occurrence of gambling and alcohol involvement? What is the effect of gambling and using alcohol at the same time? What are the effects of the recent gambling boom, with internet gambling, NCAA pools, Fantasy Football and poker tournaments? In 1999-2000, we conducted a national U.S. telephone survey that measured problem and pathological gambling. Respondents were 2631 representative U.S. adults. We assessed problem gambling as well as alcohol and drug use, abuse and dependence. Gambling approval or disapproval by family and friends, and availability of various types of gambling were also included in the interview. Distance from the respondent's home to casinos, tracks and other gambling venues was assessed by geocoding the respondent's address as well as the addresses of the gambling facilities throughout the U.S. Neighborhood descriptors (census tract and block group data) were also included, along with a data set describing state gambling laws. This 2000 survey is one of only two recent national U.S. surveys with a comprehensive coverage of gambling topics, and is by far the most suitable to be replicated for the purpose of studying secular trends in gambling. We propose to conduct another survey, similar to our 2000 survey, including incorporation of neighborhood census data, state gambling laws, and distance to gambling venues. We will analyze the combined data from both surveys. Our specific aims are: 1) To examine trends in gambling behavior and problems among U.S. adults from 2000 to the present, and also in relevant sub-groups of the population;2) To examine the relationship between gambling trends and changes in state gambling laws, changes in the density of gambling facilities, changes in U.S. neighborhoods and changes in social approval of gambling;3) to examine the relationship between gambling trends and trends in alcohol and drug involvement;4) To examine current prevalence, and the link to problem gambling, of forms of gambling that are recently growing in popularity, such as internet gambling, fantasy football and Texas Hold'em poker;and 5) To test a multi-level model of risk for gambling involvement. PUBLIC HEALTH RELEVANCE: In recent years, gambling has come to play a greater role in American life. Gambling laws have been liberalized, and gambling venues expanded. Along with this expansion has come increased concern about the negative effects of gambling, and controversy about public policy related to gambling. We cannot address these policy issues intelligently without empirical data. Is the prevalence of problem gambling in the U.S. increasing? Is the prevalence of problem gambling related to gambling laws, to the social approval of gambling, or to the availability of gambling opportunities? What is the relationship between gambling trends and trends in alcohol and drug involvement? The proposed research will be able to provide evidence on these and other questions related to legal gambling in the U.S.